Improving feedback to students

Feedback is often reported to be a weakness in surveys of student experiences. This is a complex area and it is possible that the answers conceal some other message, and that students’ understanding of feedback is different from teachers’. But feedback may have deteriorated.

Running through the 20 students currently in the department, with photosThe photo shows staff of the Dept Medicine reviewing students at the end of their 8 week attachment at Queen Elizabeth Central Hospital Blantyre (College of Medicine, University of Malawi).  Sessions like this occurred in Edinburgh in the ‘old’ curriculum, but now seem to be a rarity.  Why?

  • Students have more numerous, shorter attachments than they used to, as specialties have become narrower and more numerous
  • Doctors are more numerous and rotate faster and work shifts, so doctors (especially junior doctors) are less likely to get to know students well
  • It is difficult to find time to have meetings like this this as doctors’ working hours have become tightly regulated and shifts mean they aren’t all there at one time

Making students integral

Probably won’t fix the whole feedback issue but can’t be a bad thing?

8am handover daily includes student case presentations or X-raysStudents presenting X-rays at the daily departmental morning handover meeting, Blantyre, Malawi.

When units don’t know their students so well, they are less likely to trust and rely on them.  In Malawi students are important to patient care. In the UK, until the recent piloting of Assistantships as a rather small part of Final Year, students had been largely relieved of a real clinical role.  The ethos was that they were there to be taught, not to provide service.  The pendulum had swung away from them having a core role for fear that patients would come to harm.

It would be crazy to suggest that Malawi has got it all right, as their shortage of doctors and healthcare resources is severe – but despite that, they have time for this.  They have realised that it is in their interests, indeed, as they rely on their students so much.  It behoves us to look again at our own practice.  How can we make students more involved and part of the team again in our resource-rich environment?  A number of approaches have been suggested, but what do you think?

4 Comments

  1. Neil Turner

    3rd year medical students doing their first Medical attachment in Blantyre must get signed off that they have satisfactorily undertaken: 3 venepunctures, 2 IM injections, 2 SC injections, 3 IV lines, 3 pleural taps, 3 ascitic taps, 2 lumbar punctures, 2 urinary catheters, 1 urine dipstick, 1 NG tube, 2 blood glucose stix, and 18 case work-ups.

  2. janet

    Interestingly during the student assistantship the final years had to work the same rota as a team of docs (2 FY2, CT1, ST4) which for some was pretty tough e.g. 4 lates, followed by 4 nights. The feedback at the end of the 2 weeks was very much the fact that the benefits of being part of a team who got to know them and were able to give good feedback far outweighed the down side of working ‘fixed’ shifts that they were allocated in advance. The students also felt that the Y5 EM module should be run that way.
    So……from July for this academic year we are going to allocate students to a team for the 2 weeks, with fixed shifts……..and see how it goes! I’m sure there will be some gripes about having to work saturday night shift but thats the reality they will have soon.

    • Ed Mellanby

      That sounds brilliant Janet! Maybe if the students know that the change has come from student feedback then they will be more willing to do the Saturday night shift?!
      There are other attacments where clinicians work in teams. I know that sometimes students are allocated to a team, but perhaps there are more opportunities for this type of approach in other attachments.

  3. Neil Turner

    Yes I think there is no doubt they value being in the front line with – and I hope contributing to a team. And yes let’s roll it further if it’s successful.

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